FREE Cervical Cancer Screening Tests

ONONDAGA COUNTY, DECEMBER 30, 2022 – January is National Cervical Cancer Awareness Month, and the Onondaga County Cancer Services Program (CSP) is reminding people ages 21 and older who have a cervix to get screened for cervical cancer. Cervical cancer occurs most often in people over the age of 30. Unlike many cancers, cervical cancer can be prevented with the human papillomavirus (HPV) vaccination and regular screening tests (Pap test and HPV test) and follow-up. Screening tests can find the cells that lead to cancer. These cells can be removed before cancer starts. Screening tests can also find cancer early, when treatment may be most effective. Cervical cancer does not usually have symptoms in the beginning, which makes regular screening the key to finding it early.

Free Pap and HPV tests are available through the CSP for people ages 40 to 64 who have a cervix and have barriers, such as no health insurance, preventing them from getting the screenings and any necessary follow-up testing they may need. Services are available at many healthcare provider sites throughout the city of Syracuse and Onondaga County. “People without health insurance are less likely to get cancer screenings. Cervical cancer is most often found in those who rarely get screened or have never been screened. Our program can help people without health insurance get screened,” said Dr. Kathryn Anderson, Onondaga County Commissioner of Health.

The human papillomavirus (HPV) is the main cause of cervical cancer. HPV is a common virus that is passed from one person to another during sexual activity. Usually, HPV will go away on its own, but when it doesn’t, cervical cancer can develop over time. The HPV vaccine can prevent infection from the nine most common types of HPV. The vaccine is recommended for children at age 11 or 12, but can be given between 9 to 26 years of age. Adults between the ages of 27 to 45 who are not adequately vaccinated may benefit from the HPV vaccine. Check with your provider to determine if you should receive the vaccine. If you do not have insurance that covers the vaccine, please call (315) 435-2000 for more information on the Onondaga County Immunization Clinic.

There are two tests that can find cervical cancer early. Cervical cancer screening tests are recommended for people with a cervix between the ages of 21 to 65. People aged 21-29 should be screened regularly with Pap tests every three years. Those aged 30 and older may be screened with both Pap and HPV testing every five years. Routine screenings are an important step to help find cervical cancer early.

Whether you have health insurance or not, having cervical cancer screening tests is important. Do not delay your screening. Talk to your doctor, and if you are between the ages of 40 to 64 and do NOT have health insurance, call the Cancer Services Program at 315-435-3653 or visit the CSP website to see if you qualify for free cervical cancer screening tests. Take care of yourself and schedule your test today!

Onondaga County Health Department to Hold COVID-19 Vaccine Clinics for Ages 6 Months—3 Years

ONONDAGA COUNTY, DECEMBER 6, 2022 – Dr. Kathryn Anderson, Commissioner of Health announced that the Onondaga County Health Department will be holding two Moderna COVID-19 vaccine clinics for children ages 6 months—3 years.

The clinics will be held at the Civic Center in Downtown Syracuse on Thursday, December 8 from 9am to 12pm, and on Saturday, December 10 from 9am to 11:30am. Appointments are required and can be made online at covid19.ongov.net/vaccine/.

First and second doses of the Moderna vaccine will be offered at the clinics. Second doses will be available for children who received their first dose at least 4 weeks before the clinic date.

Dr. Anderson explained, “It is important for children starting at 6 months of age to be fully vaccinated against COVID-19. The rapid spread of the omicron variants and the potential for severe disease in young children are reasons for concern. Notably, COVID hospitalization rates are higher for children under 5 than those 5-17 years old. Please, as we head into the holidays, take steps to make sure everyone in your family is protected.”

ALL residents are urged to stay up-to-date with their COVID vaccines and make an appointment today at one of the many clinics and pharmacies listed on the convenient online Vaccine Finder tool at https://www.vaccines.gov/search/. Those who are 18+ and in need of a primary series or booster dose can make an appointment at the Onondaga County clinic being held on Tuesday, December 13 from 9 to 11:30am and 1 to 3pm at the Civic Center.

For more information about the COVID-19 vaccine and the latest recommendations, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html or call the Onondaga County Health Department at 315-435-2000.

Onondaga County Health Department to Hold MPX Vaccine Clinic

ONONDAGA COUNTY, NOVEMBER 4, 2023 – There continue to be additional cases of monkeypox (MPX) in Onondaga County, for a total of 4 confirmed cases to date. These cases are not connected, individuals have isolated, and there is little to no risk to the general population.

Vaccination is the safest way to protect yourself against MPX when given before or shortly after an exposure. For anyone at risk of contracting the disease, or at future risk of contracting the disease, vaccine is available at the OCHD clinic in Room 080 of the Civic Center by calling 315-435-3236 for an appointment. There will be an upcoming Health Department clinic at ACR Health, 627 Genesee Street, Syracuse on Friday, November 18^th from 10:00 am – 2:00 pm for both appointments and walk-ins. First and second doses will be offered. Individuals will need two doses of the vaccine, at least four weeks apart, and are considered fully vaccinated 14 days AFTER their SECOND dose. Anyone who has received a first dose elsewhere can get their second dose at any of the OCHD clinics as long as it has been four weeks since the first dose.

Prevention
Along with getting vaccinated, protect yourself by:

Always talking to your sexual partner/s about any recent illness and being aware of new or unexplained sores or rashes on your body or your partner’s body.
Avoiding close skin-to-skin contact, including hugging, kissing, cuddling and sexual activity with people who have signs like sores or rashes.
- Sores can look like pimples or blisters and may be painful and itch. The rash or sores may be located on or near the genitals or butt and can also appear on other areas like the hands, feet, chest, face, or inside mouth.
Not sharing materials (bedding, towels, clothing, utensils, cups) with someone who has signs of or been diagnosed with MPX.
Washing your hands often with soap and water or an alcohol-based hand sanitizer.
Using appropriate personal protection (like a mask and gloves) when caring for others with signs or symptoms.

Symptoms of monkeypox include fever, headache, muscle aches and backache, swollen lymph nodes, chills, exhaustion, and a rash. A rash can look like a blister, pus-filled bump, open sore, or widespread small hard bumps on the body.

If you think you may have been exposed and are experiencing symptoms, please contact your primary care provider immediately. You can learn more by texting “MONKEYPOX” to 81336 or visiting https://on.ny.gov/3RYgHuP.

Clinic Details and Registration The OCHD clinic will be held Friday November 18, 2022 from 10:00 am to 2:00 pm at ACR Health at 627 Genesee St, Syracuse NY 13204. Those receiving a first-dose vaccine will require a second dose, which will be given on Friday, December 16, 2022 at the same time slot as the first dose. Please note that individuals are not considered fully vaccinated against monkeypox until 14 days after receiving their second dose.

Increase in Overdoses in Onondaga County

Through the Onondaga County Health Department ODMAP overdose tracking system, there has been notification of 16 or more overdoses occurring in the last 24 hours. In some instances, the individual did not respond to the administration of naloxone (Narcan.) This pattern of overdoses is consistent with reports of the sedative Xylazine in other communities across the country.

Xylazine is a non-opioid sedative, analgesic, and anesthetic agent approved for veterinary use in horses and some other large animals. It slows breathing and heart rate, as well as decreases blood pressure, amplifying the sedative effects of an opioid like fentanyl or heroin. Xylazine is not considered a controlled substance, meaning it can be bought as a prescription medication from a veterinarian. This substance was identified in the journal Forensic Science International as an “emerging adulterant in abused drugs.” Across the country, Xylazine has been discovered in street drugs like fentanyl, heroin, cocaine and methamphetamines and people using drugs are often unaware of its presence.

In a situation where someone is experiencing an overdose where they do not respond to naloxone, it is recommended that:

-First, call 911 and administer naloxone and rescue breathing like you normally would.

— Start rescue breathing after giving the first dose of naloxone. It may help restart the lungs even if the person doesn’t wake up.

-If a person does not wake-up after spraying multiple doses of naloxone into their nose, continue rescue breathing or CPR until emergency services arrive

– The immediate goal is to make sure the person is getting oxygen into the brain.

-If the person starts breathing again but is still sedated, they don’t need more naloxone. Put them in rescue position and keep an eye on them.

In light of the increase of overdose occurrences, community members are urged to get trained to reverse overdoses using the drug naloxone, also known as Narcan, a medication that is available as a nasal spray and to utilize rescue breathing. Being trained to reverse overdoses is an easy way to potentially save a life. The Onondaga County Health Department provides free in-person or virtual training and also has an on-demand option that can be accessed here: https://ongov.net/health/opioids/NaloxoneTraining.html . Please contact the Mental Health and Substance Use Initiatives Program at: naloxonetraining@ongov.net with any training requests or questions. If you or someone you know needs fentanyl test strips or naloxone, they can be requested by calling or texting the Health Department’s confidential Narcan and Test Strip request line at 315-418-5365.

What is SIDS?

By Sunny Jones, Public Health Educator

October is Sudden Infant Death Syndrome (SIDS) Awareness Month. SIDS is the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old. SIDS is one of the leading causes of Infant Mortality (when a baby dies before their first birthday).

Many SIDS deaths can be linked to unsafe sleep. To reduce the risk of sleep-related infant deaths, including accidental suffocation and SIDS, the American Academy of Pediatrics recommends that infants sleep on their backs, positioned on a firm, empty surface. This surface should not contain soft objects, toys, pillows, or loose bedding.

The Mayo Clinic lists the following as risk factors for SIDS:
Sex. Boys are slightly more likely to die of SIDS.
Age. Infants are most vulnerable between the second and fourth months of life.
Race. For reasons that aren’t well understood, non-white infants are more likely to develop SIDS.
Family history. Babies who’ve had siblings or cousins die of SIDS are at higher risk of SIDS.
Secondhand smoke. Babies who live with smokers have a higher risk of SIDS.
Being premature. Both being born early and having a low birth weight increase your baby’s chances of SIDS.

Here are a few steps to help reduce the risk of SIDS and other sleep-related deaths:

Get early and regular prenatal care.
Avoid having baby sleep on a pillow, waterbed, couch, chair, or other soft surfaces.
Do not let your baby fall asleep on a surface that isn’t made for sleeping babies, such as a car seat, a feeding pillow (like the Boppy pillow), or an infant lounger.
The firm crib mattress should be covered with a fitted sheet and no other bedding. Keep soft objects and loose bedding out of the sleep area.
Do not use a crib bumper pad. In May 2022, crib bumper pads were federally banned due to their link to infant deaths.
It is recommended that infants share a room with their parents while they sleep but on a separate surface, like a bassinet or crib next to the bed until the child’s first birthday.
Breastfeeding or feeding expressed breast milk can reduce the risk of SIDS.
Dress your baby for the room temperature to avoid overheating. Signs of overheating include, sweating or feeling hot to the touch.
Smoking or using alcohol or drugs during pregnancy or after birth can put the baby at risk for SIDS. Exposure to secondhand smoke can also increase a baby’s risk, especially if a parent who smokes shares the bedroom with a baby.
Stay up to date on all recommended immunizations for you and your baby. Studies have shown that babies who receive their vaccines have a lower risk of SIDS.

Reality Check has Seen Enough Tobacco in New York State

Since 2020, U.S. cigarette smoking has dwindled to an all-time low of 12.5% according to the Centers for Disease Control and Prevention (CDC). Despite this remarkable milestone, e-cigarettes and vaping devices continue to infiltrate our youth and young adult populations nationwide. The use of flavors in tobacco products is an ongoing issue specifically pertaining to younger individuals. Reality Check, a youth-based program of New York State recognizes October 13th as “Seen Enough Tobacco Day”. The purpose of this day is to raise awareness of the tobacco industry’s irresponsibility by investing billions in tobacco marketing toward youth and minority populations in our communities.

According to the U.S. Surgeon General, young people who are exposed to consistent tobacco marketing are more likely to start smoking. The Reality Check group at the Institute of Technology at Syracuse Central (ITC) is creating posters depicting the dangerous effects of tobacco marketing on their peers that will be displayed in their school. In addition, the group posted Seen Enough Tobacco yard signs in Columbus Circle in downtown Syracuse. “We selected this area due to the high foot traffic throughout the day,” said Tobacco-Free CNY Reality Check Coordinator, Antonio Palmer. “The group wanted to ensure these messages reached as many people as possible, as education has always been the catalyst to everlasting change”.

To participate in Seen Enough Tobacco Day on Thursday, October 13, 2022, please share photos of our lawn signs on social media using #SeenEnoughTobacco and sign the Seen Enough Tobacco online petition at www.SeenEnoughTobacco.org to pledge your support.

The Reality Check program is part of Tobacco-Free CNY and works to engage local stakeholders, educate community leaders and the public, and mobilize community members and organizations to strengthen tobacco and e-cigarette policies that prevent and reduce tobacco and vape use. Efforts also focus on reducing youth exposure to harmful tobacco and e-cigarette marketing in retail settings, limiting exposure to secondhand smoke, and reducing smoking imagery in the media. For more information about Reality Check and Tobacco-Free CNY programs, visit www.tobaccofreecny.org or call 315-435-3280.

FREE Mammograms are Available

October is National Breast Cancer Awareness Month. In New York State, breast cancer is the most common cancer in women, and is the second leading cause of cancer death. One in eight women will get breast cancer at some point in their lifetime.

Many things affect a person’s chance of getting breast cancer, these are called risk factors. Some risk factors cannot be controlled, including getting older, having dense breasts, radiation to the chest area early in life, and family history/genetics. Other risk factors can be controlled. These risk factors include being overweight, not being physically active, eating unhealthy food, drinking alcohol, and smoking cigarettes.

Additional risk factors that increase your chance of breast cancer include never giving birth, never breastfeeding, or giving birth to a first child at a later age. The good news is you can lower your breast cancer risk by making healthy lifestyle choices. Remember, it is essential to see your health care provider for regular check-ups.

Do not wait to get your mammogram. Regular breast cancer screening is the key to finding breast cancer early when treatment may work best. The Onondaga County Cancer Services Program (CSP) encourages anyone who has put off their mammogram or is due for a mammogram, to call their health care provider. If you do not have health insurance, the CSP may be able to help!

Most women (about 8 out of 10) who get breast cancer do not have a family history of the disease. However, women with close blood relatives like a mother or sister who have had breast cancer are at higher risk. About 5-10% of breast cancers are thought to be hereditary, meaning they result directly from gene defects passed on from a parent. The most common cause of hereditary breast cancer is inherited defective BRCA1 and BRCA2 genes.

Breast cancer may not cause any symptoms in its early stages. If symptoms do appear, they may include the following:

a lump, thickening, or swelling in a part of the breast or underarm area
new pain in one spot that does not go away
nipple discharge other than breastmilk, including blood
pulling in of the nipple or other parts of the breast
dimpling or puckering of the breast skin
any change in the size or shape of the breast
swelling, warmth, redness, or darkening of the breast skin
itchy, scaly sore, or rash on the nipple or other parts of the breast

The Cancer Services Program (CSP) offers free breast cancer screenings to women ages 40 and over who do not have health insurance, or who experience other barriers to completing their screenings. If any follow-up tests are needed, the CSP will provide those tests too. If breast cancer is found, CSP will help enroll people who qualify in the NYS Medicaid Cancer Treatment Program for full Medicaid coverage during treatment. Services are available at many healthcare provider sites throughout the city of Syracuse and Onondaga County.

Whether you have health insurance or not, having a mammogram may save your life. If you are a woman age 40 and older and do NOT have health insurance, call 315-435-3653 or visit www.ongov.net/health/cancerscreening.html to see if you qualify for a free mammogram.

Onondaga County Health Department to Hold Monkeypox Vaccine Clinic on Thursday, September 29

The Onondaga County Health Department will be holding a monkeypox vaccination clinic for those in our community who are at risk or may be at future risk of contracting the disease. The clinic will offer both first and second doses. Those in need of a second dose must have received their first dose at least 4 weeks ago.

Individuals will need two doses of the vaccine, at least four weeks apart, and are considered fully vaccinated 14 days AFTER their SECOND dose. Anyone who has received a first dose elsewhere can get their second dose at any of the OCHD clinics as long as it has been four weeks since the first dose.

Clinic Details and Registration
The clinic will be this Thursday, September 29, 2022 from 9:00 am to 3:00 pm in the basement level of the Onondaga County Civic Center in downtown Syracuse. Parking is FREE in the Oncenter Lot.

Register for an appointment at https://monkeypox.ongov.net/vaccine/. APPOINTMENT GUARANTEES A VACCINE, but walk-ins are welcome. Vaccine availability for walk-ins will be based on the number of appointments and vaccine capacity for the day.

Those receiving the first-dose of the vaccine will require a second dose, which will be given on Thursday, October 27, 2022 at the same time slot as the first dose. Please note that individuals are not considered fully vaccinated against monkeypox until 14 days after receiving their second dose.

Learn More
Take steps to prevent getting monkeypox with these tips: https://bit.ly/3PNzbwl. Symptoms of monkeypox include fever, headache, muscle aches and backache, swollen lymph nodes, chills, exhaustion, and a rash. A rash can look like a blister, pus-filled bump, open sore, or widespread small hard bumps on the body.

If you think you may have been exposed and are experiencing symptoms, please contact your primary care provider and notify them immediately. You can learn more by texting “MONKEYPOX” to 81336 or visiting https://on.ny.gov/3RYgHuP.

Additional Mosquito Pools Found Positive for EEEV and WNV, Spraying of Cicero Swamp Planned

The Onondaga County Health Department was notified today that mosquitoes collected from traps located in the Cicero Swamp area in the town of Cicero tested positive for virus. A mosquito pool from Route 298 was positive for Eastern Equine Encephalitis virus (EEEV) and a pool from Island Road was positive for West Nile Virus (WNV). Both viruses were found earlier this season in the Cicero Swamp area. As temperatures remain warm, so will the threat of mosquito bites that can transmit disease. The Onondaga County Health Department urges residents to use personal protection measures when spending time outdoors.

The Onondaga County Health Department is making plans to conduct aerial spraying of the Cicero Swamp and immediate surrounding areas. This proactive measure is an attempt to interrupt the mosquito breeding cycles. Reducing the number of mosquitoes (although it is temporary) can reduce the number of mosquitoes available to transmit the virus to humans. The spraying is scheduled to take place on Saturday, September 10, 2022, after 6:30 pm, weather permitting. If weather or wind conditions are unfavorable on Saturday, the spraying will be conducted on the next appropriate day and will be announced through local news, social media, and other communication channels. Residents in the spray areas will be notified by phone through the 911 emergency notification system.

The designated spray areas are generally bounded on the north by Route 31, on the west by Northern Boulevard, on the south by Taft Road, and on the east by the county line (Chittenango Creek). Roads included in this area are all or parts of Route 298, Bull Street, Eastwood Road, Island Road, Cicero Center Road, Fergerson Road, Ferstler Road, and Oxbow Road. To view a map of the spraying area, visit: www.ongov.net/health/documents/SprayMapCicero.pdf.

The pesticide that will be used for aerial spraying is Perm-X UL 30-30. This pesticide is registered with the Environmental Protection Agency and the New York State Department of Environmental Conservation for this use. A copy of the pesticide label can be found on the Onondaga County Health Department website at https://www.ongov.net/health/env/documents/Perm-XUL30-30Label.pdf. A written copy of the label can be provided by calling 315-435-1649.

If you live in the spray area, from 6:30 pm to 10:00 pm on the day of the scheduled spraying, it is recommended that you:

Stay indoors and keep your windows closed for one hour after the area has been sprayed.
Keep your pets indoors if possible.
Set your window air conditioners to circulate indoor air. It is safe to use your central air conditioning.
Keep outdoor gardens covered and rinse vegetables before eating.
Be sure children’s toys, outdoor furniture, and clothes on outdoor clotheslines are brought inside. If toys or clothes are left outdoors, wash each thoroughly with soap and water before using and launder clothes before wearing them.
Close your car windows and car vents if you are driving during the spraying.

Onondaga County residents who would like to receive community alerts by wireless phones, text messages, and/or TTY may register for the Hyper-Reach Emergency Notification System through the Department of Emergency Communications—911 Center at www.ongov.net/911/notification.html. Landlines are already included in the 911 emergency notification system.

For more information about spraying and protecting yourself from mosquitoes, visit www.ongov.net/health/env/mosquitoes.html or call the Onondaga County Health Department at 315.435.1649.

Area Teens Attend Summit at Keuka College

Focus on combating tobacco industry’s influence on youth

Tobacco-Free CNY Reality Check youth from the Institute of Technology at Syracuse Central (ITC) Ali Kareem and Michelle Tran joined more than 70 teens at Keuka College for this year’s Reality Check Youth Summit held each summer to gain leadership, self-empowerment, and team-building skills to produce change in their communities. Reality Check works to expose the tobacco industry’s deceptive and manipulative marketing tactics that appeal to youth and lead to nicotine addiction.

ITC students Michelle Tran and Ali Kareem with Reality Check Coordinator, Antonio Palmer (center)

“Youth Summit was a wonderful experience for all who participated,” said Tobacco-Free CNY Reality Check Coordinator, Antonio Palmer. “The highlight for me was watching the youth in action during our activism fair. Witnessing youth from all across the state unite to create powerful messaging rejecting Big Tobacco’s marketing practices was truly a sight to behold.”

When New York State ended the sale of flavored e-cigarettes in May 2020, it was a significant step toward reducing youth tobacco use. However, e-cigarette use remains the most used tobacco product among New York State youth (22.5%). More than half of teens falsely believe e-cigarettes are harmless.

Youth will apply skills learned to raise awareness of the tobacco industry’s impact on young people. During the summit’s Activism Training Fair, youth experienced a variety of hands-on, highly visual, and engaging activities to mobilize and educate communities about Big Tobacco’s impact on young people. Ali Kareem and Michelle Tran joined their fellow Central region youth in the Chalk the Walk activity. The objective was for youth to utilize their imagination and chalk to create messages or images illuminating the tobacco industry’s negative impact on their respective community.

They shared startling information about tobacco industry marketing and its effect on youth smoking initiation, including:

The average age of a new smoker is 13 years old, and 90 percent of adult smokers say they first tried smoking by age 18.
In 2019, cigarette and smokeless tobacco companies spent $8.2 billion on advertising and promotions in the U.S. alone.
To catch the attention of youth, tobacco companies use colorful packaging that sometimes imitates the packaging of popular candy brands. Plus, tobacco product advertisements in stores are often at children’s eye level (less than three feet off the ground), and tobacco products are placed near candy, toys, and other youth-friendly items.
Menthol cigarettes, in particular, lead to increased smoking initiation among youth and young adults, greater addiction, and decreased success in quitting smoking.
Youth who initiate using menthol cigarettes are more likely to become addicted and become long-term daily smokers.

Reality Check and Tobacco-Free CNY are funded by the New York State Department of Health, Bureau of Tobacco Control, New York State Tobacco Control Program (NYSTCP). The NYSTCP aims to reduce illness, disability, and death related to tobacco use and secondhand smoke exposure, and to alleviate the social and economic burdens caused by tobacco use.

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Sources:

NYS Dept. of Health, Tobacco Control Program, StatShots 2021-Vol. 14, Numbers 1-4. Milestones in Tobacco Control: Youth Tobacco Use Declines Across All Product Types in 2020, Lowest Youth Smoking Rate on Record, StatShot Vo. 14, No.3/Sept 2021. Accessed July 2022, https://www.health.ny.gov/prevention/tobacco_control/reports/statshots/

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. BRFSS Prevalence & Trends Data CDC, 2020. Accessed July 2022, https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?rdReport=DPH_BRFSS.ExploreByTopic&irbLocationType=StatesAndMMSA&islClass=CLASS17&islTopic=TOPIC15&islYear=2020&rdRnd=54125

NYS Department of Health, Tobacco Control Program, Information about Tobacco Use, Smoking and Secondhand Smoke, Tobacco Use in NYS, 2017. Accessed July 2022, https://www.health.ny.gov/prevention/tobacco_control/

A Report of the Surgeon General “The Health Consequences of Smoking—50 Years of Progress” 2014, p. 12. Accessed July 2022, https://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf

CDC, Smoking and Tobacco Use, Tobacco Marketing. Accessed July 2022. https://tinyurl.com/tobaccomoneyspentonads

Counter Tobacco, Youth Targeting at the Point of Sale, Product Placement and Advertising. Accessed July 2022. https://countertobacco.org/resources-tools/evidence-summaries/youth-targeting-at-the-point-of-sale/

“Impact of Menthol Cigarettes on Youth Smoking Initiation and Health Disparities.” Campaign for Tobacco-Free Kids, 2021. Accessed July 2022, https://www.tobaccofreekids.org/assets/factsheets/0390.pdf.

“Impact of Menthol Cigarettes on Youth Smoking Initiation and Health Disparities.” Campaign for Tobacco-Free Kids, 2021. https://www.tobaccofreekids.org/assets/factsheets/0390.pdf